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Exotics Adoption Application

ADOPTION AGREEMENT

I agree to take over the ownership of the above mentioned animal(s) from The Moon Dog Farm (MDF). As an integral part of my ownership I agree to treat my new family member(s) with the best care that I can give. I agree never to cause harm, neglect, abuse, or abandon my new pet or allow others to do so. In the event that I can no longer take care of my adopted animal(s) I agree to contact a member of MDF at: info@TheMoonDogFarm.com or (928) 288-6097. The animal must be re- turned to the care of the sanctuary if I am unable to maintain ownership. Under no circumstances am I able to re-home the adopted animal without first contacting MDF using the above information.(Required)

Yes, I agree. *

I agree not to have this animal euthanized unless absolutely medically necessary, and that if COST of care is an issue, I will contact the MDF about allowing them to take over medical care and ownership of the animal.(Required)

Yes, I agree. *

This animal may not be kept for any purpose other than a household pet, including but not limited to; meat, fur, pet food, bait, sale, petting zoo, science project or display.(Required)

Yes, I agree. *

HOUSING AGREEMENT

I agree that if I must relocate or move from my current residence that I will take my new animal(s) with me as well as contact MDF with my new information in order to keep records current. I agree that this animal will be housed indoors at all times and will NEVER be housed in any outdoor enclosure. I agree that when/if the animal is allowed outdoors, that it will be supervised at all times.(Required)

Yes, I agree. *

I understand that a great diet is beneficial to the health and well-being of guinea pig(s) or Rabbit(s) I am applying to adopt. I agree to feed the appropriate aged Oxbow or Sherwood pellet food, daily vitamin c (for guinea pigs) ample -unlimited timothy hay and daily fresh greens. I will also make sure to have proper husbandry with habitat, toys, litter, bowls, water bottle(s) hideys, and what and will be sure to have proper enrichment toys/exercises for my pet. I understand that a member of The Moon Dog Farm go over this with me at time of interview.(Required)

Yes, I agree. *

LIABILITY

Upon signing this contract, I understand that Moon Dog Farm is no longer responsible for the financial costs of caring for this animal, including veterinary bills incurred after the adoption. I also agree that MDF is not responsible for damage that this pet may cause to my persons or property. I understand that MDF has disclosed any known medical information at the time of adoption.(Required)

Yes, I agree. *

ADOPTION FEES

	Single	Bonded Pair
Rabbits:	$125	$150
Guinea Pigs:	$40	$75
Hamsters/Gerbils/Mice:	$10	$15

The adoption fees are non-refundable donations to the Moon Dog Farm and not a purchase price for the animal(s) or any supplies that I am acquiring. If for some reason I must return/surrender the adopted animal(s), I understand that my money will not be refunded for any reason.(Required)

Yes, I agree. *

EXOTICS ADOPTION APPLICATION

First Name *(Required)

Last Name *(Required)

Date of Birth *(Required)

MM slash DD slash YYYY

Date

Driver's License Number

Phone Number *(Required)

Email *(Required)

example@example.com

Address 1(Required)

Address 2

City *(Required)

State *(Required)

Zip *(Required)

Have you lived at this address for at least 2 years?

Yes

No

If not, previous address

Do you own or rent?

Own

Rent

If rent, please provide landlord’s name and phone:

Current Occupation *(Required)

Number of Years at Current Job *(Required)

Household Information

Number of Adults in Household *(Required)

Number of Children in Household *(Required)

Ages of Children *(Required)

Have the children in the home had pets before?

Yes

No

Have all adults in household agreed to this adoption?

Yes

No

Does anyone in household have pet allergies?

Yes

No

Does anyone in the home have allergies to hay

Yes

No

If yes, who

In general, how would you describe life at your house?

How long have you been looking for a pet? *(Required)

Is this your first exotic pet?

Yes

No

If you have had pets in the past or currently have pets, please describe (name, breed/mix, age, gender, spayed/neutered, living/deceased)*(Required)

Have you ever given a pet away or relinquished one to a shelter

Yes

No

If yes, what were the circumstances?

Under what circumstances would you, or have you, euthanized a pet?

Current Veterinarian *(Required)

Veterinarian Address *(Required)

Veterinarian Phone *(Required)

New Exotic Information

Are you committed to owning your pet for the next 7-12 years?

Yes

No

How will you handle your pet’s exercise and stimulation needs?

Please describe in detail the type of habitat you will have prepared for your pet

How many hours per day will your pet be home alone ? *(Required)

Who will be your pet’s primary caregiver? *(Required)

In case of emergency, who will care for your pet? *(Required)

What do you plan to feed your pet?

Which animal are you looking to adopt? *(Required)

Describe your expectations for the amount of time it will take your pet to adjust to your new home and what you think that will look like. *(Required)

Are you willing to do research/attend training or webinars to expand your knowledge on exotic animal behavior ?

Yes

No

Please provide (3) personal references (name, relationship, phone)

Reference 1

Reference 2

Reference 3

How did you hear about us? *(Required)

The information on this application will be kept confidential. I certify that all information provided is complete and correct to the best of my knowledge.

Yes

No

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Please send donations to:
The Moon Dog Farm
PO Box 1552
Sauk Village IL 60411

Who We Are

The Moon Dog Farm is a 501c3 non-for-profit organization in South Suburbs of Chicago, IL.

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